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DocuSign Envelope ID: 72574FBA-38BB-482F-A711-18C4CFEC2EDF
<br /> Nledicil Mutual '
<br /> r ur,o , rlt,,r,rR K pl,lcF7 sioq Mecilical hofessliumd Liabillity
<br /> NON-ASSESSABLE CLAIMS MADE PO,LICY
<br /> KLN LWA L DECLARATIONS PAC L POLICY O. PG1120161
<br /> Name anal Address of"Insured Policy Period
<br /> ..........................
<br /> Ra1eigh Pathotogy Laboratory Assciciatios, PA
<br /> PO Box 1,1045 Effeclive Date:August 15,2014; 12A] A.M.
<br /> 1"t,d6gh, NC 276210 Expiration Date: August 15,20111; 12:01 AM.
<br /> Coverages 1"Amits
<br /> ..............
<br /> A - IndilMduall Professional lAabiNty.— ....... As Sclwclulc(l Rcllow
<br /> B -Mc(fical Pitactivicall(i Non-Phi �I,!'C'll y'sician Finilployces Professional LjaNhty----.... As schic(luled Bellow
<br /> C. - Per Diem Reinibursement .— — --... .. .....-............-- - -........ ............ -... ...... S 1,0010 I'm day/$70,000 per vlaim
<br /> D. MED-DiFTEMF PLI IS -$10,00,(1c(lucilible md,a co-6istuance jjlaymejtt o1'200K,, 1 S50-0100 cach clainl&l annualaggitogalle/$250,0100
<br /> pre"u evW4500-000 annual aggi,egatc
<br /> if-c-7w rYr111 Network Securily & Privacy......... ............... $50,01010,purer claim,33001,000 annual aggrcgatc
<br /> ----------------------—-------
<br /> Udorsements. PCO201 NC(09/10),,P( 0 10 1 NC(09/1(1), PE6'00 I NC k06/13),PCO501 NC'(02/13),,PE3101 NC(06/08). PE3901 NC
<br /> �(06/08),1°°E6501INC(12/13)
<br /> P
<br /> D"t Cub:clot M' Jago'egaite
<br /> .(Aeigh Pjtholq,!,y Laborawry Associatcs PA 1 V17 1978 0,000,0001/8,0010,000
<br /> Coverage 1%
<br /> 1')4mme fkvelilcy Dookhan, IMD I I/I /2013 6,000,000/8,0001,0001
<br /> MichaO A Iluening,NIL), 07/2112008 670100010/8,0010,000
<br /> Catim inc I olnuilie:^flahim" MD 11/15,120 t 3 6,000,0010/8,0001.000
<br /> Matthew Rau Myrayer"MD 06'26/20 ',
<br /> 06 (,(.1a(17000/8,00(j,000
<br /> IS,hinivas Rajagopallan, MD 03/,5,1996 6,000.00W87000,0010
<br /> Ahren Charles Rillershaus, MD 07d 1/2011 6,01001.000/8,001t),00101
<br /> Damon IFinersaon Scarborough,Jr NID 02/0 1/191/6 6,010oxil),18,00mino
<br /> Christine Norton Siffings.,NID 018/0 11 C20 10 6,000,OUO/8,0001,000
<br /> Nfillhew huncs' sny(jiof, MD 017/18/2005 6,000,0001,000,000
<br /> C I hicryl Anne Szpak,NID 0 1 l'O-ji 1991 6,000,000M,000l,0100
<br /> Stepbeiii T.P'a,rker TOTAL PW NijuNi
<br /> Medical N1 i0iiial I rumirm nce Co.of NC
<br /> 700,'S'prilIng Forest Rd
<br /> Raleigh,NC 27609
<br /> 800-662-71917 or 919-872.711"
<br /> Coullitersigilited date: J"Lly'll.el-2 5,,..20,1-4-11-11.1.11-11—
<br /> AuflZ Vz,ed Kepresentafivc
<br /> NIEL),[CAL Nil I'll U AL INSUlt.%N'Cf�'(()NIPAN)7
<br /> OFAM41 11 CAROIANA
<br />
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